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This is Laura Diet with the Becker Health

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care podcast.

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I'm thrilled today to be joined by Hill

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Martin Res, President and Chief Executive Officer of

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Uc care. Hillary is a pleasure to have

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you on the podcast today?

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It's a pleasure to be here, Laura. Thank

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you so much for the invitation.

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Now, I'm really looking forward to learning more

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about

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you and how you're thinking about growth and

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development at Uc care. But before we dive

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in, could you please introduce yourself, tell me

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a little bit more about uc care as

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well?

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Yeah. Of course. Happy to do Laura. So

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I have been at Uc care since 20

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10, but in the proud president and Ceo

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since 20 21.

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Uc care is a Minnesota based health plan

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serving individuals who get their coverage through government

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health program. So that includes Medicaid, Medicare and

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products for those who are dual eligible for

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Medicare Medicaid as well as Minnesota state based

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exchange marketplace.

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We don't offer employer based commercial coverage, all

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we do is government programs, and this allows

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us to be singular focused on the unique

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needs, of the individuals we serve.

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For a profit plan, mission base where community

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plan and it's our forties

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anniversary this year, Laura, we are celebrating

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anniversary this summer. In fact.

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We were founded in 19 84 by a

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team of providers whose thought there must be

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a better way or to serve individuals who

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are eligible for Medicaid.

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And they started in a single county and

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they strive to improve access to outcomes and

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equity for the,

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Medicaid members in this

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demonstration project.

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So while we started as a demonstration project,

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it's clearly been a very successful

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demonstration because we are still here 40 years

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later, now serving about 600000

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members. In every county in Minnesota as well

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as portions of Western Wisconsin.

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We are now the largest nonprofit government programs

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health center in Minnesota and in fact, the

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third largest in the country.

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And

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according to a recent Usa today,

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publication, we are the highest ranked health plan

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in the nation among

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plans of ever size as it relates to

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employee engagement and workplace culture.

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We are really proud of this. In fact.

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We call this our people power.

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That's amazing to hear. And you know, wow.

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What a great anniversary... 40 years this summer.

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That's a huge accomplishment and so exciting to

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hear about how you've continued to evolve over

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the years and serve the community better. Now

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from your perspective, what are some of the

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big trends and headwind that you're following right

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now?

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Yeah. Well, it's a great question, Laura. You

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know, every business as you know, it's focusing

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on the role of Ai in the organization.

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Ai has the potential to be the biggest

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innovation to hit healthcare and frankly to hit

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any industry in years, probably in our lifetime.

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Ai creates incredible opportunities in areas such as

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predictive modeling and simplifying member experience.

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More efficient operations and so much more. But

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as you know, it also comes with risk.

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Ai can bring about unintended concepts

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such as introducing bias and discrimination into decisions,

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potentially ex the health disparities that already exist

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and of course, there can be privacy concerns

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and security concerns and even ethical and moral

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concerns.

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And of course, Ai introduces the possibility of

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regulatory

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and legal challenges. And

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as you know, the health industry has already

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seen some of both. The At uc care,

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we have a team of people leading this

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work, which is oversee by a committee of

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our board to ensure it gets the highest

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level of over site. So as we build

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our Ai approach at Uc care, we are

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being very deliberate

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about introducing Ai in a way that it's

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aligned with our mission site and that directly

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benefit our members and provider.

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And we're ensuring that it aligns with our

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non nonprofit value in our strong workplace culture.

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We've also been unwavering in our commitment to

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using Ai in a way that enhances what

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makes the special and doesn't ever replace it.

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In other words, we'll ensure that we don't

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replace the human element of our service

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or the human element of the positive experience

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we create with our members.

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The human re element of the relationships we

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have with our partners

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or especially the human element of the thoughtful

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decision making that we

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make every single day.

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But we're also unwavering our commitment that any

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use of Ai will be responsible

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and ethical all the time. Every time without

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exception exception.

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And we're being just as deliberate, Laura about

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ensuring that we avoid the common tip pitfalls

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that can be associated with the use of

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Ai and help care. For example, let's talk

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for a moment about how Ai may support

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prior

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authorization process. Uc care already limits the use

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of Pa to only those services that may

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be unsafe,

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unnecessary or redundant for members or those services

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that lack evidence based criteria

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or documented improvements.

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Our intent is always to minimize member disruption

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and provider burdens and never to delay access

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to needed care.

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So will limit the use of Ai and

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prior authorization to being a decision support tool

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to help ensure consistent

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application of medical necessity criteria, but it will

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not be used to deny cure. Any questions

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about whether care is necessary or appropriate will

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you evaluate a any case by case basis

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by our clinical

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professional.

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Laurie you also asked about headwind, that Care

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and other organizations are facing. So in terms

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of the headwind,

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every

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organization, especially healthcare

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organizations that are experiencing the impact of the

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largest

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cybersecurity breach in the nation's history.

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Healthcare is a popular target for cyber criminals

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unfortunately

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and this recent breach reminded us of the

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vulnerabilities of our interconnected systems and processes

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and the need to be ever vigilant and

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staying ahead of cyber cybersecurity threats.

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It was also a reminder to have strong

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business continuity plan, callback connection it's not just

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solely depend on a single vendor for essential

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services.

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At Care, we're proud of the proactive steps

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we've taken over the years,

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to build business continuity programs and to safeguard

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our systems in our data and will continue

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to prioritize this work going forward.

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That's great to hear it. In such a

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good reminder of so many different factors that

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have an impact on how operations work in

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and can really, be thoughtful approach to, as

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you mentioned Ai as well as cybersecurity and

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some of the other risks that are are

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ahead of us. No. It's I'm wondering how

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are you thinking about growth for the future?

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What does that mean for you at uc

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care?

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Yeah. I I appreciate that question, Lauren. This

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first talk generally about their business reasons that

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many organizations speak to grow. First, of course,

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as organizations grow against scale. Which allows them

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to operate more efficiently and effectively and contribute

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to their bottom line

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and girls for organizations can also lead to

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product

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diversification or geographic

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diversification, which allows organizations to have a broader

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portfolio of business signs that further supports the

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organizational health.

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When we think about growth at You care,

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we're not just thinking about the business value

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of growth, although those are of course important.

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But as a highly mission driven

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nonprofit community plans, our primary

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motivation for girls is to allow more individual,

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benefit from a unique programs and services

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that we offer to our health plan numbers.

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Let's talk about Medicaid, for example.

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To As I said earlier, we've been serving

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Minnesota eligible for Medicaid for 40 years. And

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we serve more Medicaid enroll in Minnesota that

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any other plan about... 400000

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minnesota.

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So we've developed, signed and innovated our Medicaid

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offerings over the decades,

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enabling us to serve our Medicaid members with

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an expertise that's based on years of

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with providers

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meeting

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organizations and government partners, to respond to their

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very localized needs.

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We like to say that we're the bridge

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between a complex Medicaid system and the communities

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we serve.

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So, Laura, when we talk about growth, we

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think it's equally important to talk about what

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we are not going to do as it

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is to talk about what we will do.

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First, we will never lose sight of the

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important work we do in Minnesota. We've been

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serving minnesota for decades and that will never

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change.

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The growth efforts will not distract us from

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continuing to serve to partner to innovate in

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our current market.

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Second, as we explored growth including geographic expansion,

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we won't simply replicate what we do in

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Minnesota in new markets.

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We're proud of what we've accomplished in Minnesota.

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So what certainly will be elements of those

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capabilities that will form the foundation in new

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markets.

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But we're a community plan and that means

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we don't have an initial playbook.

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Even when we grow and we're eventually operating

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in multiples days, we'll never have a national

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playbook because we customize our approach based on

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the specific needs of the communities in which

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we operate.

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As I said, we'll leverage what was learned

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in Minnesota, but we'll never come paste it

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into a new market.

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And also, Laura, we don't make assumptions about

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what local communities needs. When we talk about

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being a community based plan. It means that

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we learn about those needs, but asking communities

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about their experiences,

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we ask them about their challenges and their

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priorities,

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and then we c create solutions,

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with them to meet their.

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Finally,

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we will never let go of our culture,

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which as I said before, we call it

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our people power.

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People come to you care because they believe

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in our mission and then they stay because

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they see they feel the impact that they

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having honor our members. And our commute every

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single day.

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When I started at Uc care, Laura in

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20 10 and we had

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we were much smaller. We now have 4

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times more employees than we had in 20

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10. And despite that tremendous growth, we've never

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lost sight of our mission for our values

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in our culture and we remember will, even

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as we grow over the years.

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That's amazing here. And, you know, I really

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love the idea of continuing to build upon

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that culture and and really valuing the people

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within the organization and and seeing how they

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can drive success.

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And and 2, another thing that you said

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that stood out to me was the idea

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of personalization being able to really embrace any

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community that you're working in, understand the intricacies

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and nuances and then customizing your approach, in

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in way your,

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best being able to serve people of that

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community. I think that's so powerful and something

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broadly in health care. I hear more and

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more about on a regular basis. This is

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just having that type of personalization and customization,

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really really is

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beneficial and keys. So that's great to hear

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is already baked into a part of who

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you are in in the mission of uc

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care,

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before I wrap up here, I'm wondering, could

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you tell me about a project or initiative

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from the last year that's yielded the best

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results?

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Yeah. Thank you for that question, Laura. There

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there's so many successes that I'm proud of

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as I reflect on the past year ranging

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from things like

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population health initiatives. That are moving the dial

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and addressing health disparities,

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the large technology

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implementations and so much more. But what I'd

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like to share with you today is the

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work we did in support of the Medicaid

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red

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process.

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As the largest Medicaid plan in Minnesota, we

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felt we had both an opportunity and a

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responsibility

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to ease the burden of this process

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on the members

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within in our state. And so our planning

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work started well below before the public health

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emergency ended.

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So we had additional support and services ready

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to go on day 1. For example,

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We expanded an existing internal team that we

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have at U care that we called our

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Key coverage team.

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This team connected 1 on 1 with some

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of our highest risk members to help them

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complete their renewal

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application.

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We also partnered with a local navigator

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increase our capacity for this 1 on 1

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assistant.

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And taken together, we were able to have

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more than 50000

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member touch point related to the renewal process

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over the past year.

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We did additional things like c developing

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educational materials and partner of with Minnesota Permanent

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human services,

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and we educated members about renewal requirements using

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linguistic and culturally appropriate

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messages and approaches.

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We helped fund assistance program that providers and

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community agencies, and we sent them information about

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which of their patients, our members, they

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are impacted, so they could provide personalized support

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from their perspective. For example,

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we offered some grants to help some providers

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have staff available to support renewal process

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and application questions where their patients came in

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for a doctor's appointment.

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And then we had a community wide marketing

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strategy that included targeted digital marketing as well

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as Tv ads featuring uc care employees helping

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people with fair renewal.

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The red

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process was uncharted territory for everyone involved. So

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it was important to be nimble and be

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ready to adapt continual change through Alta traffic.

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So we worked closely with our partners to

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adjust and evolve our model to best serve

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our members throughout what was a 12 month

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process in Minnesota.

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So as the process wraps up in Minnesota,

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we're still analyzing the total impact Member, but

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we believe that you care exceeded both local

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and national projections in terms of the percentage

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of members that we retain.

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Mostly in a Medicaid program, but some in

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1 of the products we offer through our

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state's marketplace, where as you know, monthly premiums

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are often offset by subsidies to make those

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products more affordable.

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We're still grateful for our strong partnership with

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a state to achieve these results, as well

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as our partnerships with providers, counties and community

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organizations. And of course,

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none of this would have been possible without

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the strengths of the nearly

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1700

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extraordinary employees or for Uc care, which, as

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I said before we call our people power.

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I love that. Hillary. Thank you so much

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for joining us on the podcast today. This

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has been a fascinating discussion. I've learned a

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lot and really appreciate. The time that I've

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had with you today. Thank you so much,

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and I look forward to connecting you again

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soon. Thank you, Laura.